介入合并硬化剂治疗食道静脉曲张破裂出血临床疗效

目的观察经皮经肝胃冠状静脉栓塞与硬化合并治疗食道静脉曲张破裂出血的疗效。方法16例肝硬化食道静脉曲张破裂出血患者行及经皮经肝胃冠状静脉栓塞和内镜下硬化治疗,观察止血效果并发症。结果15例患者均1次止血成功,1例治疗后8h再次出血,行急诊手术治疗。主要反应为胸骨后疼痛,持续时间为2～7d,对症处理后消失,3、6个月后再次复查食道胃底曲张静脉明显改善,3例10d左右行内镜下再次硬化治疗(因第1次硬化剂量少或治疗不完全)。结论经皮经肝胃冠状静脉栓塞合并内镜下硬化是一种有效的食道胃底静脉曲张治疗方法。

Percutaneous transhepatic coronary vein occlusion and endoscopically of sclerotherapy to treat esophagastric variceal hemorrhage

Objective] To observe the effects of percutaneous transhepatic coronary vein occlusion and endoscopically of sclerotherapy to treat esophagogastric variceal hemorrhage in cirrhotic patients. Methods] Sixteen cirrhotic patients suffering from esophagogastric variceal hemorrhage were treated with percutaneous transhepatic coronary vein occlusion under X-ray guiding and endoscopically of sclerotherapy; Results] Fifteen patients were successfully treated with coronary vein occlusion and endoscopically of sclerotherapy. One patient rebled 6 hours of the treatment and were successfully treated with transjugular intrahepatic portosystemic shunt. The emergency hemoststic treatment efficacy was 93.7%, and successful occlusion occurred in 100%. All patients were followed up 1~3 months. There were 2 patients who suffered from rebleeding. Conclusion] Percutaneous transhepatic coronary vein occlusion under the X-ray guiding and endoscopically of sclerotherapy is efficient to treat esophagogastric variceal hemorrhage in cirrhotic patients.